Issue link: https://beckershealthcare.uberflip.com/i/1173622
37 ANTIBIOTIC RESISTANCE & STEWARDSHIP Core antibiotic stewardship strategy can be implemented successfully at smaller hospitals By Anuja Vaidya P ost-prescription audit and review, a key antibiotic stewardship interven- tion, can be successfully implemented at community hospitals, which oen have limited resources, according to a study pub- lished in JAMA Network Open. Researchers conducted a multicenter clinical trial at four community hospitals in North Carolina from October 2014 through October 2015. They examined the feasibility of implementing two antibiotic stewardship interventions recommend- ed by the Infectious Diseases Society of America: • A modified preauthorization, in which the prescriber had to receive pharmacist approv- al for use of the antibiotic aer the first dose • Post-prescription audit and review, in which the pharmacist would discuss antibi- otic appropriateness with the prescriber aer 72 hours of therapy Each hospital performed the modified preauthorization and post-prescription audit and review interventions for six months at a time. During the study, pharmacists performed 1,456 modified preauthorization interventions and 1,236 post-prescription audit and review interventions. Antibiotic therapy was deemed inappropriate twice as oen during the post-prescription audit and review phase of the study period than the preauthorization period. Pharma- cists recommended dose change more oen during the modified preauthorization inter- vention; however, de-escalation of antibiotic therapy occurred more oen during the post-prescription audit and review. Overall antibiotic use decreased during the post-prescription audit and review interven- tion as compared with historical controls, but not during the modified preauthoriza- tion period. n Hospitals are stepping up antibiotic stewardship efforts, CDC says By Mackenzie Bean M ore hospitals are operating an- tibiotic stewardship programs that meet all CDC standards, ac- cording to a new report from the agency. The CDC report summarizes new data and improvement efforts the agency has rolled out since publishing its last antibi- otic resistance report in 2017. The CDC found 3,816 hospitals nation- wide had antibiotic stewardship pro- grams that met its seven core standards in 2017, nearly two times more hospitals than in 2014. The seven core elements are leader- ship commitment, accountability, drug expertise, action, tracking, reporting and education. The CDC aims to achieve 100 percent program compliance among all partici- pating hospitals by 2020. n 9-month experiment eliminates MRSA transmission in NICU By Anuja Vaidya A series of sequential interventions helped a neonatal intensive care unit at a tertiary care hospital achieve zero methicillin-resistant Staphylococcus aureus transmission, according to a study pub- lished in the American Journal of Infection Control. After analyzing current inpatient infection control practices at the hospital, researchers developed a series of interventions including: • Reinforcing staff awareness of infection control practices via regular education and updates • Providing faster feedback • Ensuring easy availability of cleaning equipment • Individualizing items for all patients • Keeping personal belongings away from clinical areas • Revising inpatient admission workflow for babies transferred from other hospitals The quality improvement project, wherein the interventions were imple- mented and data was examined, was conducted over a nine-month period. Researchers found that the NICU achieved zero MRSA transmission to pa- tients who previously did not have MRSA. Hand hygiene and environmen- tal hygiene compliance improved from a median rate of 87.1 percent and 82.2 percent, respectively, before the interventions to 100 percent median rate for both after the interventions. n